St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRY CRANIAL 2 HOL BONE PLT W/TAB

Facility

$292.46

Service Code	HCPCS C1713
Hospital Charge Code	40203401
Hospital Revenue Code	278
Min. Negotiated Rate	$102.36
Max. Negotiated Rate	$307.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$160.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$175.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$146.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.16
Rate for Payer: EmblemHealth Commercial	$146.23
Rate for Payer: Fidelis Medicare Advantage	$307.08
Rate for Payer: Group Health Inc Commercial	$146.23
Rate for Payer: Group Health Inc Medicare	$102.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$146.23
Rate for Payer: Hamaspik Choice Inc Medicare	$146.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$190.10

STRY C-SHAP FRACT PLT, 4 HOLES

Facility

$611.42

Service Code	HCPCS C1713
Hospital Charge Code	40204715
Hospital Revenue Code	278
Min. Negotiated Rate	$305.71
Max. Negotiated Rate	$305.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$305.71
Rate for Payer: Hamaspik Choice Inc Medicare	$305.71

STRY C-SHAP FRACT PLT, 4 HOLES

Facility

$611.42

Service Code	HCPCS C1713
Hospital Charge Code	40204715
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$641.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$336.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$366.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$305.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$351.57
Rate for Payer: EmblemHealth Commercial	$305.71
Rate for Payer: Fidelis Medicare Advantage	$641.99
Rate for Payer: Group Health Inc Commercial	$305.71
Rate for Payer: Group Health Inc Medicare	$214.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$305.71
Rate for Payer: Hamaspik Choice Inc Medicare	$305.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$397.42

STRY DRILL 2.0X62X13 MM RE PIN

Facility

$253.46

Hospital Charge Code	40204212
Hospital Revenue Code	272
Min. Negotiated Rate	$88.71
Max. Negotiated Rate	$202.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$139.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$126.73
Rate for Payer: Aetna Government	$126.73
Rate for Payer: Brighton Health Commercial	$190.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$202.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.35
Rate for Payer: Group Health Inc Commercial	$126.73
Rate for Payer: Group Health Inc Medicare	$88.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.73
Rate for Payer: Hamaspik Choice Inc Medicare	$126.73

STRY DRILL BIT 1.9 MM

Facility

$150.00

Hospital Charge Code	40203442
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

STRY DRILL BIT 1.9MM

Facility

$150.00

Hospital Charge Code	40204724
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

STRY DRILL BIT 2.0 MM

Facility

$530.00

Hospital Charge Code	40203441
Hospital Revenue Code	272
Min. Negotiated Rate	$185.50
Max. Negotiated Rate	$424.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.00
Rate for Payer: Aetna Government	$265.00
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.40
Rate for Payer: Group Health Inc Commercial	$265.00
Rate for Payer: Group Health Inc Medicare	$185.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$265.00
Rate for Payer: Hamaspik Choice Inc Medicare	$265.00

STRY DRILL BIT 2.0MM

Facility

$530.00

Hospital Charge Code	40204723
Hospital Revenue Code	272
Min. Negotiated Rate	$185.50
Max. Negotiated Rate	$424.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.00
Rate for Payer: Aetna Government	$265.00
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.40
Rate for Payer: Group Health Inc Commercial	$265.00
Rate for Payer: Group Health Inc Medicare	$185.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$265.00
Rate for Payer: Hamaspik Choice Inc Medicare	$265.00

STRY EASYCLP CMPR STPL 15X15X15MM

Facility

$4,620.00

Hospital Charge Code	40008268
Hospital Revenue Code	279
Min. Negotiated Rate	$1,617.00
Max. Negotiated Rate	$3,696.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,541.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,310.00
Rate for Payer: Aetna Government	$2,310.00
Rate for Payer: Brighton Health Commercial	$3,465.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,696.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,141.60
Rate for Payer: Group Health Inc Commercial	$2,310.00
Rate for Payer: Group Health Inc Medicare	$1,617.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,310.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,310.00

STRY FEM DIS FIX PEG

Facility

$1,226.00

Service Code	HCPCS C1776
Hospital Charge Code	40206081
Hospital Revenue Code	278
Min. Negotiated Rate	$613.00
Max. Negotiated Rate	$613.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.00
Rate for Payer: Hamaspik Choice Inc Medicare	$613.00

STRY FEM DIS FIX PEG

Facility

$1,226.00

Service Code	HCPCS C1776
Hospital Charge Code	40206081
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,287.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$674.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$735.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$704.95
Rate for Payer: EmblemHealth Commercial	$613.00
Rate for Payer: Fidelis Medicare Advantage	$1,287.30
Rate for Payer: Group Health Inc Commercial	$613.00
Rate for Payer: Group Health Inc Medicare	$429.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.00
Rate for Payer: Hamaspik Choice Inc Medicare	$613.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$796.90

STRY FRACTURE PLT, 4 HOLES W/BAR

Facility

$591.36

Service Code	HCPCS C1713
Hospital Charge Code	40203425
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$620.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$325.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$354.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$295.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.03
Rate for Payer: EmblemHealth Commercial	$295.68
Rate for Payer: Fidelis Medicare Advantage	$620.93
Rate for Payer: Group Health Inc Commercial	$295.68
Rate for Payer: Group Health Inc Medicare	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.68
Rate for Payer: Hamaspik Choice Inc Medicare	$295.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$384.38

STRY FRACTURE PLT, 4 HOLES W/BAR

Facility

$591.36

Service Code	HCPCS C1713
Hospital Charge Code	40203425
Hospital Revenue Code	278
Min. Negotiated Rate	$295.68
Max. Negotiated Rate	$295.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.68
Rate for Payer: Hamaspik Choice Inc Medicare	$295.68

STRY GUIDEWIRE W/CALIBRA 3.2X300

Facility

$100.45

Service Code	HCPCS C1769
Hospital Charge Code	40203696
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$105.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$60.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.76
Rate for Payer: EmblemHealth Commercial	$50.22
Rate for Payer: Fidelis Medicare Advantage	$105.47
Rate for Payer: Group Health Inc Commercial	$50.22
Rate for Payer: Group Health Inc Medicare	$35.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.22
Rate for Payer: Hamaspik Choice Inc Medicare	$50.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.29

STRY GUIDEWIRE W/CALIBRA 3.2X300

Facility

$100.45

Service Code	HCPCS C1769
Hospital Charge Code	40203696
Hospital Revenue Code	278
Min. Negotiated Rate	$50.22
Max. Negotiated Rate	$50.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.22
Rate for Payer: Hamaspik Choice Inc Medicare	$50.22

STRY HERL SCR NON-LCK 2.7X18MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	40204244
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

STRY HERL SCR NON-LCK 2.7X18MM

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	40204244
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

STRY HOLE BLRANON PLA PLA

Facility

$2,140.00

Service Code	HCPCS C1713
Hospital Charge Code	40009286
Hospital Revenue Code	278
Min. Negotiated Rate	$1,070.00
Max. Negotiated Rate	$1,070.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,070.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,070.00

STRY HOLE BLRANON PLA PLA

Facility

$2,140.00

Service Code	HCPCS C1713
Hospital Charge Code	40009286
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,247.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,177.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,284.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,070.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,230.50
Rate for Payer: EmblemHealth Commercial	$1,070.00
Rate for Payer: Fidelis Medicare Advantage	$2,247.00
Rate for Payer: Group Health Inc Commercial	$1,070.00
Rate for Payer: Group Health Inc Medicare	$749.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,070.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,070.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,391.00

STRY HYDROSET BLJECTABLE CE

Facility

$5,212.00

Hospital Charge Code	40009734
Hospital Revenue Code	272
Min. Negotiated Rate	$1,824.20
Max. Negotiated Rate	$4,169.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,866.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,606.00
Rate for Payer: Aetna Government	$2,606.00
Rate for Payer: Brighton Health Commercial	$3,909.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,169.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,544.16
Rate for Payer: Group Health Inc Commercial	$2,606.00
Rate for Payer: Group Health Inc Medicare	$1,824.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,606.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,606.00

STRY INTERM SHORT PLT RT

Facility

$2,888.00

Service Code	HCPCS C1713
Hospital Charge Code	40203437
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,032.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,588.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,732.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,444.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,660.60
Rate for Payer: EmblemHealth Commercial	$1,444.00
Rate for Payer: Fidelis Medicare Advantage	$3,032.40
Rate for Payer: Group Health Inc Commercial	$1,444.00
Rate for Payer: Group Health Inc Medicare	$1,010.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,444.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,444.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,877.20

STRY INTERM SHORT PLT RT

Facility

$2,888.00

Service Code	HCPCS C1713
Hospital Charge Code	40203437
Hospital Revenue Code	278
Min. Negotiated Rate	$1,444.00
Max. Negotiated Rate	$1,444.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,444.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,444.00

STRY INTERM STAND PLT LT

Facility

$2,781.00

Service Code	HCPCS C1713
Hospital Charge Code	40204208
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,920.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,529.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,668.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,390.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,599.08
Rate for Payer: EmblemHealth Commercial	$1,390.50
Rate for Payer: Fidelis Medicare Advantage	$2,920.05
Rate for Payer: Group Health Inc Commercial	$1,390.50
Rate for Payer: Group Health Inc Medicare	$973.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,390.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,390.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,807.65

STRY INTERM STAND PLT LT

Facility

$2,781.00

Service Code	HCPCS C1713
Hospital Charge Code	40204208
Hospital Revenue Code	278
Min. Negotiated Rate	$1,390.50
Max. Negotiated Rate	$1,390.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,390.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,390.50

STRYK 12 HOLE TIBIAL PLT

Facility

$4,894.30

Service Code	HCPCS C1713
Hospital Charge Code	40008271
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,139.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,691.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,936.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,447.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,814.22
Rate for Payer: EmblemHealth Commercial	$2,447.15
Rate for Payer: Fidelis Medicare Advantage	$5,139.02
Rate for Payer: Group Health Inc Commercial	$2,447.15
Rate for Payer: Group Health Inc Medicare	$1,713.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,447.15
Rate for Payer: Hamaspik Choice Inc Medicare	$2,447.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,181.30

Know your out-of-pocket cost for care.

All Charges